Bonding with Baby: Why Ultrasound is Turning Women Against Abortion

MARK STRICHERZ

The manipulation of language has long been one of the hallmarks of the pro-choice position. But with ultrasound, words no longer matter so much: The abstract melts into the concrete and the personal. This powerful emotional appeal will continue to grow as 3-D ultrasound enters the mainstream.

His
baby had seemed real to him from the moment when Rosemary spoke of abortion; but
it had been a reality without visual shape — something that happened in the dark
and was only important after it happened. But here was the actual process taking
place. Here was the poor ugly thing, no bigger than a gooseberry, that he had
created by his heedless act. Its future, its continued existence perhaps, depended
on him. Besides, it was a bit of himself — it was himself. Dare one dodge such
a responsibility as that?

George Orwell, Keep
the Aspidistra Flying

Ebony
Smith was once only a street corner away from getting an abortion. Last October,
Ebony, 17, was walking to her local Planned Parenthood clinic in the South Bronx.
"I was scared and I was just about to finish high school and I didn't really
know what to do," she says, recalling how she was vomiting nearly every day
and how she feared her parents' reaction to the pregnancy. "I thought that
[abortion] was my only option."

On her way to the
clinic, she eyed a large billboard on the side of a building; it read, "Free
Pregnancy Tests." She decided to check it out and went inside Expectant Mother
Care, a crisis pregnancy center. The tests confirmed that she was six weeks pregnant.
A counselor told her about abortion — how a doctor vacuums the embryo or fetus
out of the mother's womb as you would a stray piece of popcorn on the carpet,
and the guilt and bleeding that can ensue. That was one reason she decided not
to abort.

The other was later seeing images of the fetus
on the center's 3-D ultrasound machine. The tiny black-and-white images amazed
her.

"I didn't realize that's something inside of
you," she says excitedly. "That's when I decided I was not going to
have an abortion. I could see the hands and the feet, and I could hear the heartbeat.
It sounded like horses galloping — da-dum-da-dum-da-dum," she laughs.

Aside from helping her decide not to abort, the sonogram image did something else:
It prompted her to work hard to graduate. "I knew I had to finish
high school. It motivated me," she says. Less than seven months after she
saw the sonogram, Josiah Collado was born. Ebony enrolled this fall at the State
University of New York at Binghamton and plans to marry Nelson Collado next year.

In
many ways, Ebony's case is typical. New evidence suggests that ultrasound plays
a key role in persuading women not to have abortions. Psychologists say the reason
for this is maternal-fetal bonding, the experience Ebony had when she saw and
heard the heartbeat of little Josiah for the first time. Prenatal scientists have
discovered that ultrasound triggers those feelings even in the first trimester
two to three months earlier than they had thought. And now that 3-D and 4-D
ultrasound is going commercial — General Electric now runs a TV ad for its 4-D
machine — many think that maternal bonding will have an even greater effect on
pregnant women.

In short, ultrasound has become a major
force in the country's abortion landscape. It has galvanized crisis pregnancy
centers, which report seeing many more clients since the arrival of the new technology.
And it is giving the pro-life cause a new tool to help persuade women to choose
life.

Yet
the vast majority of pregnant women in this country aren't as lucky as Ebony.
The crisis pregnancy center she went to not only had an ultrasound machine — a
service offered by only 341 of 1,800 centers in the nation, according to Heartbeat
International, a Columbus, Ohio-based nonprofit — the machine is 3-D, a relatively
rare technology. If it hadn't been for these things, Ebony's pre-born baby would
have ended up like the 1.2 million that are aborted every year. This ought to
change. And yet unless government steps in to help, it won't.

From
Stories to Data

For decades, evidence about ultrasound's
impact on abortion was merely anecdotal. In an oft-cited 1983 article in the New
England Journal of Medicine, Drs. John C. Fletcher and Mark I. Evans found
that the viewing of a sonogram image "in the late first or early mid-trimester
of pregnancy, before movement is felt by the mother, may also influence the resolution
of any ambivalence toward the pregnancy itself in favor of the fetus."

But
in the nearly two decades since the appearance of this report, no researchers
appear to have followed up on it. Neither Lawrence D. Platt, the past president
of the American Institute for Ultrasound in Medicine, nor Delores H. Pretorius,
a professor in the radiology department at the University of California at San
Diego and a leading authority on 3-D ultrasound, could recall a single study on
the topic. The federal government has similarly failed to look at the issue; ultrasound
still isn't listed among the reasons for the decade-long drop in abortions. "Our
society doesn't deal well with abortion. There's such a divergence between pro-life
and pro-choice people," Pretorius explains.

Yet Pretorius,
who is pro-choice, acknowledges ultrasound's power to change minds about abortion.
Women find it "harder to abort their baby after seeing the image. I mean
it's harder even for women with Tay-Sachs disease [a fatal genetic disorder that
affects the brain]. They don't know whether the baby has the disease," she
says.

Others agree. Eric Keroack, the medical director
of A Woman's Concern, a crisis pregnancy center in Boston, has just completed
an unpublished article on the topic. His study compares two 18-month periods in
the center's recent history — before it used an ultrasound machine (July 1998
through 1999) and after it began using one (October 2000 through April 2002).
Throughout, the type of clients was the same: women who told staff they were considering
abortion. Of the 366 women tracked in the non-ultrasound phase, 58 percent aborted.
But of the 434 women tracked in the ultrasound period, only 24 percent aborted.
The abortion rate fell by 59 percent. And women were almost twice as likely to
give birth to their babies. During the non-ultrasound phase, 33 percent of the
women went on to give birth. That number jumped to 63 percent when the center
had an ultrasound machine. (Nine percent of the women in the first cohort miscarried,
as compared with 10 percent in the second cohort.)

Keroack,
who says that he performed 30 to 35 abortions himself during his medical residency
at Tufts University and early days as an OB-GYN, is up-front about his study's
chief flaw — it couldn't follow the 35 percent of clients who didn't respond.
One Washington, D.C. — area ultrasonographer, speaking on the condition of anonymity,
said he doubted that 63 percent of women would choose life after seeing the sonogram.
He agreed that sonograms persuade women to remain pregnant but estimated that
figure was between 20 to 33 percent. Nevertheless, even those figures represent
a major step for the pro-life cause.

Even pro-choicers have
acknowledged the sonogram's power to change women's minds. Francesco Angelo, the
medical director of the Family Planning Center in Mineola, New York, was quoted
in the February 24 New York Times as saying, "The bottom line is no
woman is going to want an abortion after seeing a sonogram."

But others are slower to grasp the significance of the new technology. In a February
2 Associated Press story, Kate Michelman, the president of the National Abortion
and Reproductive Rights Action League (NARAL), disparaged antiabortion groups
that encourage ultrasound use. Such groups, she said, fail to respect "women's
capacity to understand what goes on in our bodies." At least one woman featured
on NARAL's own Web site wouldn't agree. Shannon Lee Dawdy says that she and her
husband "went for a routine ultrasound, and seeing our child for the first
time made the pregnancy real for me" (emphasis added). (Dawdy aborted
because the fetus had anencephaly, a rare neural tube defect.)

Maternal
Bonding

Dawdy's feelings actually are relatively
new in human history. Before ultrasound was used, a woman had less reason to feel
attached to her baby during the first 16 to 18 weeks of pregnancy. The in-utero
child was still too small to be felt, let alone seen. (Which is why early American
law followed English common law in distinguishing this "pre-quickening"
period from a "quickening" period.) The maternal bonding phenomenon
seemed to begin at about 16 to 18 weeks into the pregnancy, when the mother could
feel the baby kick in the womb.

Ultrasound has changed all
this. Even during the first trimester, a woman who saw a sonogram image of her
unborn child now felt attached to her baby. That is, she wanted to know and protect
her child. For the image on the screen isn't just any tiny human — a generic photo
of fetal development could show her that. It is hers, a human life she
has helped create, a moving baby with a beating heart. It becomes impossible to
refer to the baby as "uterine contents" or "the pregnancy"
or a "product of misconception" (the sort of dehumanizing language favored
by the New York Times). "There is a personalization of the fetus or
embryo. The woman can see a hand and face move," Platt said.

In fact, scientists no longer really dispute the phenomenon. Numerous studies
in the United States, Canada, and Europe have all found strong evidence for it.
One early study showed that women who saw sonogram images early in pregnancy knew
much more about their baby. In a 1980 article in the Journal of Obstetrics,
Gynecologic, and Neonatal Nursing, three authors interviewed 100 women at
a Pennsylvania hospital. The women's answers were the same regardless of class
or race. Before the scan, the mothers believed their fetuses or embryos were inactive
they described their child as "sleeping," "floating," "growing,"
and "moving" (in order of frequency). After viewing the scan, they saw
that the pre-born child was active — the mothers' responses in order now were
"moving," "kicking," "growing," and "relaxing."
The authors termed this change in views "considerable."

Maternal bonding has also been linked to changed behavior among expectant mothers.
For example, a 1982 study in the journal Psychological Medicine found that
in a randomized control group, women who saw a sonogram image of their fetus at
14 weeks or earlier and were given detailed information about prenatal development
were less likely to smoke and drink than those women who had not seen their fetus's
image.

The Vital Two Months

The
real problem with ultrasound isn't the technology. It's that most women don't
use the technology when it really matters: when they're deciding whether to abort.
Instead of being done during the first trimester, when women are most likely to
abort, sonograms are usually done when women are 16 to 18 weeks pregnant, according
to gynecologists and ultrasonographers. By that time, it's too late.

Part
of the problem is that ultrasound was long viewed by doctors with suspicion and
indifference. The first modern scanner was used in 1966 in Germany, but for years
the technology was practically unknown. Roe v. Wade doesn't even mention
sonograms, despite citing such medical advances as artificial insemination and
the morning-after pill. Up through the early 1980s, the technology's medical uses
were scoffed at. In the standard textbook on ultrasound, Ultrasonography in
Obstetrics and Gynecology, author Peter Callen opens one chapter this way:
"When I began my involvement with diagnostic ultrasonography two decades
ago, this chapter would have been considered ludicrous."

But around this same time sonogram images were improving, with the advent of real-time
scanners and, a few years later, digital scan converters. In 1984 a famous 28-minute
film, The Silent Scream, depicted a 12-week-old fetus being aborted. Yet
fears of the technology persisted. The National Institutes of Health declined
that year to endorse routine ultrasound screening in pregnancy, citing concerns
about women's safety and doubts about its medical values. Both concerns turned
out to be groundless, but doubts remained. Only a little more than half of the
roughly four million pregnant women who were pregnant in 1990 used sonograms to
detect pregnancy, according to the Centers for Disease Control and Prevention.

Since then, sonogram use has steadily risen. By 2000, 67 percent of pregnant women
were using it. Ultrasound figures prominently in magazines like Parents,
while a woman having a sonogram is today a familiar scene in daytime soap operas.
Ultrasound machines have also turned into big business, with the industry reaping
$1 billion in profits last year. And 3-D machines, which have been around since
the mid-1980s, are finally entering the commercial sphere. They can show a fetus
as young as nine and a half weeks with a head, arms, belly, and legs.

But
many insurance companies are unwilling to pay for more than one ultrasound scan,
which typically costs several hundred dollars, and they prefer to have it done
later in the pregnancy. In poor parts of Los Angeles, Platt notes, a woman won't
receive a scan till she's 25 weeks pregnant. The American College of Obstetricians
and Gynecologists, the industry's association, doesn't recommend that all pregnant
women undergo an ultrasound scan.

The abortion industry
isn't exactly an enthusiastic backer of the early use of ultrasound either. Clinics
don't require women to undergo sonograms before 14 weeks, let alone to view the
image of the pre-born child. The National Abortion Federation, whose members perform
half of the nation's 1.2 million abortions annually, has no mandatory sonogram
policy for its 450 clinics in the United States, according to Vickie Saporta,
the executive director of the National Abortion Federation.

At
least one former abortion-industry worker has claimed that her clinic turned the
ultrasound monitor away from women. Jo Ann Appleton, now the president of the
Society of Centurions, a pro-life organization for former abortion-industry workers,
was the former head nurse at Commonwealth Clinic in Falls Church, Virginia, from
1984 to 1989. She says her clinic performed ultrasounds only when the woman requested
it: "We didn't show it to them [otherwise]. The idea was to keep their anxiety
at a lower level."

Does Uncle Sam Want Them?

Pro-life
organizations and churches tend to be the only institutions pushing for early
sonograms. But since there's little money to be made in helping the poor and vulnerable,
their budgets are absurdly meager; they do as much as they can with the little
they're given. And this appears to be true even of crisis pregnancy centers that
use sonograms.

I recently visited the Rockville Crisis Pregnancy
Center, outside Washington, D.C. Located just off a bus stop in Rockville, Maryland,
the center is on the second floor of a mustard-brown brick building. The counseling
rooms are windowless, brightly lit, and painted in bright yellow and pink. The
ultrasound machine itself looks unimpressive — a manila-colored EUB-405 Hitachi
that weighs 40 pounds: about the size of a 12-inch TV.

Most
of the clinic's clients are poor, from an ethnic minority, or in college, according
to executive director Gail Tierney. They learn about the center not through the
mainstream media, but via the Internet, the yellow pages, billboards, and word
of mouth. Ultrasound scans are generally performed only one night a week, because
it's hard to find a doctor who will work for free. This year's whole budget is
$269,000, Tierney says.

As she talks, I detect a lingering
bitterness toward national pro-choice leaders and groups. When I told Tierney,
whose center was unfairly maligned in a story by the Washington Post, that
one abortion clinic in the D.C. area assured me they perform ultrasounds before
and after the abortion, Tierney replied, "Oh, that's good — show her what's
left afterwards."

And yet Tierney can claim to have
saved hundreds and maybe thousands of lives. On her wall she has pictures of past
clients with their children. Getting ultrasound "was the best thing we've
done in 15 years. The majority of the abortion-vulnerable women don't choose abortion
after seeing their baby," Tierney says. The center sees 200 such women every
year.

Still, Rockville is one of only two crisis pregnancy
centers in the D.C. area with an ultrasound machine. By contrast, there are 15
abortion providers.

One of the major organizations trying
to improve the ratio is the National Institute for Family and Life Advocates,
a small Virginia-based nonprofit. Its mission is to convert such counseling centers
into fully equipped medical offices that would offer ultrasound scans. Of the
789 centers it represents legally, about 200 have operating ultrasound machines,
according to Thomas Glessner, the group's president and founder. NARAL recently
named Glessner's nonprofit institute an "anti-choice organization to watch"
in its 60-page booklet, "Choice Action Kit: Unmasking Fake Clinics."

Glessner
himself is an unusual pro-life leader. He grew up in a small logging and farming
town in Washington state, where his father was a Protestant minister. He inherited
from his father a concern for social justice, and this concern led him to protest
against the Vietnam War and serve as an officer in the Young Democrats Club at
the University of Washington. Now 50, he is still very much a child of the 1960s.
He and I met for lunch recently at Pete's Diner on Capitol Hill. "I Get Around"
blared from the radio. Glessner, wearing a green-and-brown-patterned shirt, said,
"Yeah, man, cool. The Beach Boys!" and started dancing a quick
jig.

The story of how Glessner's organization became interested
in sonograms highlights the precarious nature of the crisis pregnancy center movement.
In the early 1990s, a handful of state attorneys general clamped down on pregnancy
centers, which were accused of practicing medicine illegally. In fact, many of
them had been administering pregnancy tests illegally without a nurse or
physician. It was in this climate that Glessner's group embraced sonograms — not
so much because it was thought they'd persuade women to choose life but for political
reasons. "It was a defensive posture," Glessner said plainly. "It
was done to avoid the claim, You're illegally practicing medicine.'"

The ultrasound machines ended up attracting new clients. "We saw a twofold
increase in the number of women coming in, and there was a huge increase
in the number of abortion-minded women who changed their mind," he said.

With
impressive figures like that, Glessner is seeking to enlist federal support. He
cowrote a bill in Congress, sponsored by Rep. Cliff Stearns (R-Fla.), that would
help nonprofit health clinics to buy ultrasound equipment, authorizing $3 million
this year in federal grants.

While that's pocket change
by congressional standards, Glessner believes it could bring down the country's
still-high abortion rate. A basic 2-D ultrasound scanner costs $20,000 to $25,000.
If health clinics persuaded state, local, or business leaders to pick up the other
half of the cost, they could buy nearly 500 machines. Enacting that bill would
also represent an important step by the federal government on behalf of unborn
human life. (In April, Alabama mandated that women seeking an abortion must undergo
an ultrasound exam, although they are not required to look at the image.)

Stearns's
bill went nowhere on Capitol Hill this year. But with a Republican-controlled
Congress next year, its odds of passing are strong. President George W. Bush certainly
knows about the power of ultrasound: At the Born-Alive Infants Protection Act
signing ceremony in Pittsburgh, Pennsylvania, on August 5, he said, "Today,
with sonograms and other technology, we can clearly see that unborn children are
members of the human family. They reflect our image, and they are created in God's
own image."

From Debating to Seeing

Indeed
if compassionate conservatism is to mean anything at all, it should mean supporting
the early use of ultrasound. What better use of government dollars is there? Sonograms
not only improve quality of life. Poor women provide better prenatal care after
seeing them (this helps explain why three pro-choice black members of Congress,
who represent poor districts like Newark, New Jersey, and the south side of Chicago,
support Glessner's legislation). They save lives. Ask any woman who's faced a
crisis pregnancy, if she was lucky enough to have used one.

The
manipulation of language has long been one of the hallmarks of the pro-choice
position. But with ultrasound, words no longer matter so much: The abstract melts
into the concrete and the personal. This powerful emotional appeal will continue
to grow as 3-D ultrasound enters the mainstream. Embryos and fetuses, which represent
the first of the six stages of human life (followed by infancy, childhood, puberty,
adolescence, and adulthood), may at last be recognized — and protected — as human
persons.

Acknowledgement

This article is reprinted with permission
from the Morley Institute a non-profit education organization. To subscribe to
Crisis magazine call 1-800-852-9962.

The Author

Mark Stricherz is an independent writer whose articles have appeared in The Washington Post, Chicago Tribune, The Weekly Standard, The New Republic, Christianity Today, Commonweal, and the National Catholic Register. He blogs for Get Religion and Inside Catholic. Mark lives in Washington with his wife, Angy, and their daughter, Grace. They are parishioners at St. Peter's Catholic Church on Capitol Hill. Mark Stricherz is the author of Why the Democrats Are Blue: Secular Liberalism and the Decline of the People's Party (Encounter Books).